Holistic approach to prevent, manage diabetes

A patient takes a blood glucose test.

There are currently over 5.4 million Filipinos who have diabetes, a group of diseases marked by too much glucose, or sugar, in the bloodstream due to problems with how their bodies produce or use insulin.

Ten per cent of these individuals have type 1 diabetes, for which no known prevention exists and require lifelong insulin therapy. The majority (90 per cent) suffer from type 2 diabetes, which occurs when the pancreas eventually fails to produce enough insulin to maintain a normal blood glucose level, or when a patient is unable to use the insulin their body is producing.

The buildup of sugar in the patient's bloodstream must be managed in order to prevent if not delay the onset of more serious if not deadly complications.

What is more alarming, according to the most recent (2013) Food and Nutrition Research Institute survey, is the fact that another 7.4 million Filipinos have a condition called prediabetes, which puts them at high risk of developing type 2 diabetes later in life.

Major contribution

"Why does this matter? For starters, diabetes is the major contributor to heart disease and stroke, peripheral arterial disease and nerve damage. It is also one of the leading causes of blindness, kidney failure and nontraumatic foot amputations. While genetics (family history) is a strong component of risk for developing type 2 diabetes, studies show that lifestyle change, more importantly, losing weight by eating a healthy diet and being more physically active, can cut your risk in half," said Dr. Bien Matawaran, president of the Philippine Society of Endocrinology, Diabetes and Metabolism.

The objective, according to Matawaran, is for those with prediabetes to never cross the line of having full-blown diabetes and for those with diabetes to effectively manage their blood glucose levels along with their blood pressure and cholesterol.

"While diabetes is a challenging disease to manage successfully, it has been proven that patients with good diabetes self-care behaviour can attain excellent glycemic control," he said.

Matawaran added that while insulin and metformin remain the recommended first-line drugs for type 1 and type 2 diabetes respectively, the addition of blood glucose-lowering drug lixisenatide may further improve diabetes management.

"Studies have shown that the addition of lixisenatide to the usual therapy lowers the risk of hypoglycemia or abnormally low blood glucose levels that has been a problem among diabetics as this could lead to seizure and unconsciousness if not treated immediately," he said.

A new study also finds that lixisenatide did not increase risk of cardiovascular events including heart failure in patients with type 2 diabetes and acute coronary syndrome. This is important considering that prior studies have established that other glucose-lowering drugs have been associated with increased risk of cardiovascular disease. The findings of the Evaluation of Lixisenatide in Acute Coronary Syndrome trial were presented at the European Society of Cardiology Congress 2015.

While it is important for people at higher risk of diabetes and those who are newly diagnosed with type 2 diabetes to stick to their drug treatment plans, Matawaran said the best and proven approach is a holistic one that incorporates lifestyle changes.

While it may be a challenge to stick to a diet plan or exercise regimen, the doctor suggested to turn to their smartphones for help.

"The capabilities of today's smartphones go well beyond sending e-mail and surfing the Web-the millions of Filipinos living with diabetes can now be important health tools. Smartphone may play double duty as a diabetes tracking or a preventive tool adding that related apps are even more convenient and enjoyable to use," he said.

Smartphone apps

Matawaran said smartphone apps make it easy to record the results of your blood sugar tests and your insulin values, if you use insulin to manage your diabetes.

"On the other hand, a free app like the MyFitnessPal, enables you to watch your diet since it features an easy-to-use calorie counter and diet tracker that offers a massive nutrition and calorie database. You can even mark your favourite foods (including meals from popular restaurants), scan barcodes to log packaged foods, customise your diet goals and create progress reports," Matawaran said. He added that as more users become aware of the potential of these apps, they will have a better grasp of their diabetes management and, in turn, live healthier and more productive lives.

Another interesting app is the ControlMyWeight that helps you set weight goals, become aware of your eating habits and track your progress visually. The app works on the premise that being overweight is a risk factor for developing type 2 diabetes and losing even 5 per cent to 7 per cent of total body weight can help significantly.

A number of the apps for diabetes management also have medication and appointment reminders built in to help patients adhere to their diabetes treatment plan.